炎症负荷在童年期虐待和青少年非自杀性自伤行为关联中的作用

童年期虐待（CA）经历是青少年非自杀性自伤行为（NSSI）发生的重要危险因素，但两者关联的生物学基础尚待阐明。本研究首先在3 000名初一至初三学生中开展横断面调查，分析不同类型CA经历与炎症负荷（以所选炎症指标的蛋白和基因转录水平计算）和青少年既往NSSI的关联效应；同时以其中1 000名初一学生建立人群队列，开展为期2.5年、每半年1次的随访，进一步分析不同类型CA经历对高炎症负荷和新发NSSI的预测作用，以及累积炎症负荷对新发NSSI的预测作用，探讨炎症负荷在不同类型CA与青少年NSSI关联中的中介效应；而后引入析因设计，根据随访期NSSI新发情况以及是否伴有关键类型CA经历选择样本，测量外周血巨噬细胞炎症基因启动子区DNA甲基化程度，试图揭示CA与NSSI关联中炎症负荷升高的生物学机制。通过上述研究，以期验证“炎症负荷升高是CA经历青少年NSSI增加的重要生物学基础”的研究假说。

The adolescents who have experienced childhood abuse demonstrated a higher risk for non-suicidal self-injury behaviors (NSSI), however the study of its biological mechanism is rare. The cross-sectional study will be administered among 3000 students from grade 1 to grade 3 in junior schools. The inflammatory burden will be assessed by the levels and gene expression of the selected inflammatory cytokines. The relationship between different types of childhood abuse, inflammatory burden and past non-suicidal self-injury behaviors will be analyzed based on cross-sectional data. Then a total of 1 000 students from grade 1 will be prospectively recruited during 2.5 years follow-up, and the subjects were assessed every 6 months. The predictive value of childhood abuse on inflammatory burden and NSSI, the cumulative effect of inflammatory burden on NSSI will be analyzed in the follow-up study. The role of inflammatory burden in the relationship between different types of childhood abuse and non-suicidal self-injury behaviors can be assessed. Factorial design will be used after the follow-up study, the samples can be selected by the critical type of childhood abuse and the presence of NSSI during follow-up. The DNA methylation level of peripheral blood macrophage cell in inflammatory gene promoter regions can be measured to reveal the biological mechanisms of inflammatory burden increase. Then the hypothesis that elevated of inflammatory burden represent one pathway by which childhood abuse influences NSSI will be clarified.